Care Manager & Team Lead - Care Coordination (Remote/Imperial)

Community Health Plan of Imperial Valley; Oregon; Hybrid; USD 85,000 - 125,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

401k plan

Job summary

Community Health Plan of Imperial Valley is seeking a Care Manager to lead a team of Care Coordinators responsible for case management, health management, and transition of care activities for Imperial County members.

The role requires an active California RN license, 3+ years leading care coordinators, and strong knowledge of managed care. You will ensure regulatory compliance, collaborate with the healthcare team, and manage resources to improve member outcomes.

Qualifications

• Active California RN license without restriction.
• Minimum 3 years leading care coordinators.
• 3+ years in management, case management, disease management, or managed care.
• Knowledge of managed care principles with emphasis in care management/coordination.
• Clinical knowledge and critical thinking to assess whole-person care needs.
• Proficiency with Outlook, Word, Excel and case management programs.
• Experience partnering with healthcare team members.

Responsibilities

• Provide direction and guidance to the care coordination team to implement model of care and regulatory requirements.
• Manage caseloads for the team considering medical/psychosocial needs.
• Maintain electronic case management documentation in HIPAA-compliant systems.
• Complete training requirements and implement changes.
• Promote multidisciplinary collaboration and engagement of family and caregivers.
• Audit case management assessments and care plan development for timeliness and completeness.
• Monitor TOC assessments and contact timeframes per TOC protocols.
• Participate in audits (remote or onsite).
• Create business requirement documents and training materials.
• Assist with care coordination for resources and services for members.

Skills

Team leadership

Care coordination

Managed care knowledge

Nursing clinical judgment

HIPAA compliance

Outlook/Word/Excel

Interdisciplinary collaboration

Education

CA RN license

Tools

Case management software

Job description

Community Health Plan of Imperial Valley is seeking a Care Manager to lead a team of Care Coordinators responsible for case management, health management, and transition of care activities for Imperial County members.

The role requires an active California RN license, 3+ years leading care coordinators, and strong knowledge of managed care. You will ensure regulatory compliance, collaborate with the healthcare team, and manage resources to improve member outcomes.